Hispanics with Chronic Hepatitis C May Develop More Advanced Fibrosis

Recent research has increasingly revealed racial/ethnic differences in the progression of hepatitis C and response to therapy, though the reasons for these variations remain poorly understood.

In the June 22, 2006 online edition of the American Journal of Gastroenterology, researchers reported that Hispanic individuals were more likely to develop advanced fibrosis compared with non-Hispanic white patients.

The researchers analyzed data from 169 Hispanic and 63 white patients at a Los Angeles hepatitis clinic.

Results

On average, the Hispanic patients were older than white patients; in addition, Hispanics were more likely:

To have had a blood transfusion (40% vs 21%);
To be obese (body mass index greater than 30) (47% vs 21%);
To have diabetes mellitus (16%vs 5%);
To have liver steatosis (79% vs 47%).

Independent predictors of liver steatosis were:

Hispanic ethnicity (OR 3.8; 95% CI 1.7-8.7; P = 0.001);
Obesity (OR 5.7; 95% CI 2.3-14.1; P = 0.0002).

Compared with whites, Hispanics also had a higher average fibrosis stage (3.3 +/- 2 vs 2.3 +/- 6.9; P = 0.001), a higher grade of necroinflammation (6.4 +/- 1.8 vs 5.6 +/- 1.6; P = 0.002), and a faster fibrosis progression rate (0.14 per year vs 0.09 per year; P = 0.0002).

Independent predictors of a fibrosis stage of 4 or greater were:

Older age at liver biopsy (OR 1.1; P < 0.0001);
Presence of diabetes (OR 2.9; P = 0.02);
Grade 1-2 steatosis (OR 2.3; P = 0.03);
Higher necroinflammatory grade (OR 1.7; P < 0.0001);
Higher AST/ALT level (OR 4.3; P = 0.01);
Higher serum bilirubin level (OR 5.4; P < 0.0001).

Conclusion

The researchers concluded that, "this study confirms that Hispanics have more advanced hepatic fibrosis than non-Hispanic whites." Worse fibrosis was related to older age, higher necroinflammatory grade, and greater prevalence of hepatic steatosis and diabetes among this population.

7/18/06

Reference
S Verma, M Bonacini, S Govindarajan, and others. More Advanced Hepatic Fibrosis in Hispanics with Chronic Hepatitis C Infection: Role of Patient Demographics, Hepatic Necroinflammation, and Steatosis. American Journal of Gastroenterology. June 22, 2006 [Epub ahead of print].